Effect of seasonal changes on frequency of eclampsia in patients presenting to Ayub Teaching Hospital.

  • Aneesa Fawad Gynae B Unit, Ayub Teaching Hospital, Abbottabad, Pakistan
  • Bushra Zardad Gynae B Unit, Ayub Teaching Hospital, Abbottabad, Pakistan
  • Humaira Jadoon Gynae B Unit, Ayub Teaching Hospital, Abbottabad, Pakistan
  • Ayesha Ismail Gynae B Unit, Ayub Teaching Hospital, Abbottabad, Pakistan
Keywords: Eclampsia, Seasonal Variation, Maternal and perinatal morbidity

Abstract

Introduction: Eclampsia is an acute obstetrical emergency carrying high maternal and perinatal morbidity and mortality. High blood pressure during pregnancy after 20 weeks of gestation is associated with proteinuria and generalized tonic-clonic convulsions. The purpose of the study is to observe seasonal variation in the presentation of eclampsia in a tertiary-level hospital.

Methods: This is two years study conducted in the Gynae A unit, Ayub teaching hospital, Abbottabad, from January 2021 to December 2022. The study included all the patients admitted to the unit with eclampsia. It included antenatal patients and patients who developed eclampsia in labour or perpurium. Patients with a history of fits due to epilepsy or any other neurological disease were excluded from the study. 

Results: The total number of patients admitted with eclampsia during this period was 88 (1.22 %). The majority of patients were in the age group between 21 to 35 years (78.3%). There were 52 primigravidas out of 88(59.1%). There were 46 multigravidas (40.9%). 78 patients out of 88(88.6 %) belonged to areas more than 25 kilometres away from a medical facility. The season was cross-tabulated with different variables, and no statistical significance was found.

Conclusion: Eclampsia is a severe obstetrical emergency usually involving young primigravidas with poor socioeconomic status and no antenatal care. Primary prevention is regular antenatal care. Early referral and time management will reduce maternal and perinatal morbidity and mortality. The incidence of eclampsia is more in the fall and winter seasons.

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Author Biographies

Aneesa Fawad, Gynae B Unit, Ayub Teaching Hospital, Abbottabad, Pakistan

Professor, Gynae B Unit, Ayub Teaching Hospital, Abbottabad, Pakistan

Bushra Zardad, Gynae B Unit, Ayub Teaching Hospital, Abbottabad, Pakistan

Registrar, Gynae B Unit, Ayub Teaching Hospital, Abbottabad, Pakistan

Humaira Jadoon, Gynae B Unit, Ayub Teaching Hospital, Abbottabad, Pakistan

Assistant Professor, Gynae B Unit, Ayub Teaching Hospital, Abbottabad, Pakistan

Ayesha Ismail, Gynae B Unit, Ayub Teaching Hospital, Abbottabad, Pakistan

Postgraduate trainee, Gynae B Unit, Ayub Teaching Hospital, Abbottabad, Pakistan

References

Allen R, Rogozinsko E, Sivaraja Singam P, Khan KS, Thangaratinam S. Effect of diet and life style based metabolic risk modifying interventions on pre eclampsia: A meta analysis. Acta Obstet Gynecol Scan. 2014; 3(10):973-85.

DOI: https://doi.org/10.1111/aogs.12467

Chaiworapongsa T, Chaemsaithong P, Korzeniewski SJ, Yeo L, Romero R. Preeclampsia part 2: prediction, prevention and management. Nat Rev Nephrol. 2014; 10(9):531-40.

DOI: https://doi.org/10.1038/nrneph.2014.103.

Winter N, Tsasaris V. Latest development. Management and treatment of pre eclampsia. J Gynecol Obstet Biol Reprod. 2008; 37:5-15.

DOI: https://doi.org/10.1016/j.jgyn.2007.09.008.

Shaikh F, Abbas S, Baloch I, Talpur S, Yousfani S, Hashmat F. Frequency and outcome of eclampsia. Gomal J Med Sci. 2016; 14(4):200-2.

Duckitt K, Harrington D. Risk factors for preeclampsia at antenatal booking: systematic review of controlled studies. Bri Med J. 2005; 330(7491):565.

DOI: https://doi.org/10.1136/bmj.38380.674340.E0

Halimi S, Halimi SM. Eclampsia and its association with external factors. J Ayub Med Coll Abbottabad. 2010; 22(3):110-2. PMID: 22338432

Magnus P, Eskild A. Seasonal variation in the occurrence of preeclampsia. Int J Obstet Gynaecol. 2001; 108(11):1116-9.

DOI: https://doi.org/10.1111/j.1471-0528.2003.00273.x.

Jamelle RN. Eclampsia: is there a seasonal variation in incidence? J Obstet Gynaecol Res. 1998; 24(2):121-8.

DOI: https://doi.org/10.1111/j.1447-0756.1998.tb00062.x

Ghosh U, Deb D, Mondal SK, Das AK. Seasonal variation in the occurrence of eclampsia: a three year retrospective cohort study in a tertiary centre in eastern India. J Evol Med Dent Sci. 2013; 2(44):8629-38.

Subramaniam V. Seasonal variation in the incidence of preeclampsia and eclampsia in tropical climatic conditions. BMC Women's Health. 2007; 7(1):1-5.

DOI: https://doi.org/10.1186/1472-6874-7-18

Janani F, Changaee FN. Seasonal variation in the prevalence of eclampsia. J Family Med Prim Care. 2017; 6(4):766-9.

DOI: https://doi.org/10.4103/jfmpc.jfmpc_132_17

Modesti PA, Morabito M, Bertolozi I, Massetti L, Panci G, Lumachi C, et al. Weather related changes in 24 hours blood pressure profile: effects of age and implication for hypertensive management. Hypertension. 2006; 47(2):155-61.

DOI: https://doi.org/10.1161/01.HYP.0000199192.17126.d4

Rosenthal T. Seasonal variation in blood pressure. Am J Geriatr Cardiol. 2004; 13(5):267-72.

DOI: https://doi.org/10.1111/j.1076-7460.2004.02563.x

Bodnar M, Catov J, Simhan H, Holick M, Powers R, Roberts J. Maternal vitamin D deficiency increases the risk of pre eclampsia. J Clin Endocrinol Metab. 2007; 92:3517-22.

DOI: https://doi.org/10.1210/jc.2007-0718

Haugen M, Brantsoeter A, Trogstad L, Alexander J, Roth C, Magnus P, et al. Vitamin D Supplementation and reduced risk of pre eclampsia in nulliparous women. Epidemiol 2009; 20(5):720-6.

DOI: https://doi.org/10.1097/EDE.0b013e3181a70f08

Hlimi T. Association of anemia, pre eclampsia and eclampsia with seasonality: a realist systematic review. Health Place. 2015; 31:180-92.

DOI: https://doi.org/10.1016/j.healthplace.2014.12.003.

Nasiri R, Shadmehri A, Ghiassi P, Fraz M, Farsibaf M. Association of meteorological factors and seasonality with pre eclampsia: A 5 years study in northeast of Iran. Clin Exp Hypertens. 2014; 36(8):586-9.

DOI: https://doi.org/10.3109/10641963.2014.881847

Tam WH, Sohata DS, Lau T, Li CY, Fung TY. Seasonal variation in pre eclampsia rate and its association with ambient temperature and humidity in early pregnancy. Gynecol Obstet Invest. 2008; 30;66(1):22-6.

DOI: https://doi.org/10.1159/000114252.

Andrew RD. Seizures and acute osmotic changes : clinical and neurophysiologic aspects. J Neurol Sci. 1991; 101(1):7-18.

DOI: https://doi.org/10.1016/0022-510x(91)90013-w.

Pasantes-Morales H, Tuz K. Volume changes in neurons: hyper excitability and neuronal death. Contrib Nephrol 2006; 152:221-40.

DOI: https://doi.org/10.1159/000096326.

Chakrapani M, Shenoy D, Pillai A. Seasonal variation in the incidence of hyponatremia. J Assoc Physicians India. 2002; 50:559-62. PMID: 12164409

Wellington K, Mulla ZD. Seasonal trend in the occurrence of preeclampsia and eclampsia in Texas. Am J of Hypertension 2012; 25(1):115-9.

DOI: https://doi.org/10.1038/ajh.2011.173

TePoel MRW, Saftlas AF, Wallis AB. Association of seasonality with hypertension in pregnancy: a systematic review. J Reprod Immunol. 2011; 89(2):140-52.

DOI: https://doi.org/10.1016/j.jri.2011.01.020

Published
2023-07-09
How to Cite
1.
Fawad A, Zardad B, Jadoon H, Ismail A. Effect of seasonal changes on frequency of eclampsia in patients presenting to Ayub Teaching Hospital. JSTMU [Internet]. 9Jul.2023 [cited 13May2024];6(1):32-7. Available from: https://j.stmu.edu.pk/ojs/index.php/jstmu/article/view/238